In the rapidly ageing Korean population, diabetes occurrence has increased in elderly patients. Elderly diabetes is accompanied by various diabetes-related and geriatric functional disorders. Dietary and nutritional status should be prioritized in elderly diabetes patients. Diet therapy should consider the clinical characteristics and functional status of elderly diabetes patients; nutritional therapy should aim to improve quality of life, prevent complications, and manage geriatric syndromes. Considering the difficulties in changing habitual meal patterns or food preferences, nutritional evaluation is performed through accurate nutritional status analysis. Identifying malnutrition risk factors and implementing dietary correction are important. Moreover, elderly patients use various medications. Because the kidney or liver function is accompanied by a decrease or another diet is already being used as a dietary supplement, the application of the principle of dietary therapy may differ depending on the drug or disease. Additionally, considering the high hyperglycemia or hypoglycemia risk, continuous education regarding regular meals, proper dietary maintenance, and sudden changes in blood sugar is necessary. Additionally, difficulties in chewing, dysphagia, and physical activity level should be considered. If patients experience difficulties in chewing or swallowing food, recipes must be changed, choosing easy-to-digest foods. The selection and recipe of the food should be applied differently, because nutrient imbalance may be caused if the elderly living alone or the caregiver needs to take a meal. In conclusion, nutritional management of elderly diabetes patients should follow the basic guidelines of blood glucose management; however, continuous education is necessary to enable individualized clinical nutrition treatment based on health, environmental, and economic factors.